New study shows significant environmental benefits of home-based outpatient parenteral antimicrobial therapy (OPAT)

University Hospitals Coventry and Warwickshire (UHCW) NHS Trust have partnered with Baxter Healthcare Limited (Baxter) and Environmental Resources Management to publish the results of a first of its kind report - The environmental impact of intravenous antimicrobial therapies: a comparison of OPAT and inpatient administration care pathways.

The report highlights the significant benefits of OPAT, in comparison to the traditional inpatient model of intravenous (IV) antimicrobial therapy. OPAT is a method of giving medicines to patients intravenously, that are well enough to be discharged out of hospital care and can be treated at home.

The results of the study show that there is a substantial reduction in both water usage (78%) and waste generated (91%) during self-administered OPAT treatment in the home.

This publication will support more home based therapies, especially OPAT services which is in line with the NHS’ Green Plan and recommendation from Lord Darzi’s 2024 report stating that healthcare providers should support services that allow more people to be treated in their own surroundings.

Dr Steven Montgomery-Laird, Consultant Physician in Medical Microbiology, one of two COpAT (complex outpatient antimicrobial therapy) Consultants at UHCW, and one of the authors of the study said:

“It was a privilege to work with a multidisciplinary team to produce a framework that has demonstrated the importance of OPAT services in order to improve the environmental cost of keeping patients in a hospital setting by getting them home. We hope that this world first report will allow more OPAT services to grow or be developed and play a part in improving the lives of more patients through quicker discharge back to their own surroundings.”

The study also found that nurse administered OPAT, either in the home or in an outpatient department, resulted in much lower use of water, generation of waste and CO2 emissions compared to the inpatient pathway.

Ann Cole, Senior Government Affairs Manager for Baxter in the United Kingdom and author of the published report said: “We have a direct responsibility in the healthcare industry to explore ways to reduce our climate footprint wherever possible.

“With the growing shift towards home-based care and associated patient independence, cost and resource benefits already established, we conducted this investigation to better understand the environmental impact of the outpatient IV antibiotic care pathway.

To treat as many patients as possible and minimise nursing resources required to deliver OPAT, where possible, patients are given training and support to be able to manage their therapy in their home or sometimes a caregiver or family member are trained to support.

Both the NHS and Baxter share organisational goals to reduce carbon emissions, with the NHS targeting net zero emissions or direct operations by 2040.